Reliability and Validity of Hypothetical Scenarios for Estimating Willingness to Pay (Wtp) Per Quality Adjusted Life Year (Qaly) in Indonesia Setting

Kristina, Susi Ari; Endarti, Dwi; Andayani, Tri Murti; Rokhman, M. Rifqi

doi:10.22159/ijpps.2017v9i12.22657

Cited by 3 publications

(6 citation statements)

References 24 publications

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“…The CEAC is a plot of the probability of the intervention being cost-effective (y-axis) for a range of willingness to pay thresholds per unit improvement in outcome (x-axis) [51]. Initially, for the cost-utility analysis the WHO recommendation of three times GDP per capita [52, 53] or a calculation based on estimates of opportunity costs [54] were considered to approximate an Indonesian willingness-to-pay threshold, but recent research on the Indonesian willingness-to-pay threshold for medical intervention enabled a more exact analysis [55].…”

Section: Methodsmentioning

confidence: 99%

Can General Practitioners manage mental disorders in primary care? A partially randomised, pragmatic, cluster trial

et al. 2019

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BackgroundFor a decade, experts have suggested integrating mental health care into primary care to help bridge mental health Treatment Gap. General Practitioners (GPs) are the first port-of-call for many patients with mental ill-health. In Indonesia, the WHO mhGAP is being systematically introduced to its network of 10,000 primary care clinics as an add-on mental health training for pairs of GPs and Nurses, since the end of 2015. In one of 34 provinces, there exists an integrated care model: the co-location of clinical psychologists in primary care clinics. This trial evaluates patient outcomes among those provided mental health care by GPs with those treated by clinical psychologists in primary care.MethodsIn this partially-randomised, pragmatic, two-arm cluster non-inferiority trial, 14 primary care clinics were assigned to receive the WHO mhGAP training and 14 clinics with the co-location framework were assigned to the Specialist arm. Participants (patients) were blinded to the existence of the other pathway, and outcome assessors were blinded to group assignment.All adult primary care patients who screened positive for psychiatric morbidity were eligible. GPs offered psychosocial and/or pharmacological interventions and Clinical Psychologists offered psychosocial interventions. The primary outcome was health and social functioning as measured by the HoNOS and secondary outcomes include disability measured by WHODAS 2.0, health-related quality of life measured by EQ‐5D-3L, and resource use and costs evaluated from a health services perspective, at six months.Results153 patients completed the outcome assessment following GP care alongside 141 patients following Clinical Psychologists care. Outcomes of GP care were proven to be statistically not inferior to Clinical Psychologists in reducing symptoms of social and physical impairment, reducing disability, and improving health-related quality of life at six months. Economic analyses indicate lower costs and better outcomes in the Specialist arm and suggest a 50% probability of WHO mhGAP framework being cost-effective at the Indonesian willingness to pay threshold per QALY.ConclusionGeneral Practitioners supported by nurses in primary care clinics could effectively manage mild to moderate mental health issues commonly found among primary care patients. They provide non-stigmatising mental health care within community context, helping to reduce the mental health Treatment Gap.Trial registrationClinicalTrials.gov NCT02700490

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Section: Methodsmentioning

confidence: 99%

Can General Practitioners manage mental disorders in primary care? A partially randomised, pragmatic, cluster trial

et al. 2019

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“…We developed 3 versions of scenarios namely treatment, terminal illness and lifesaving described elsewhere. 18 Each respondent was assigned to imagine hypothetical health state and Euroqol-five-dimensions (EQ-5D-5L)-Visual Analogue Scale (VAS) instrument was to measure utility score associated with the assigned hypothetical health state. The EQ-5D-5L describes health status across five dimensions mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, each with five response levels: no, slight, moderate, severe, and extreme/unable.…”

Section: Questionnaire Of Health Statesmentioning

confidence: 99%

Difference of Responses Among Face to Face, Telephone, and Online Survey: A Pilot Study in Measuring Willingness to Pay Per Qaly of Three Health Conditions

Kristina¹,

Endarti²,

Andayani³

et al. 2019

Int. Res. J. Pharm.

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This study examines responses to Willingness to pay (WTP) questions across face to face, telephone, and online modes of administration. The three modes of survey data sets used in this study and delivered to different sample group for a total of 90 respondents conveniently. Dichotomous bidding followed by open-ended questions was employed to examine respondents' WTP for three scenarios. Descriptive statistics were applied to explain demographic and characteristics as well as the WTP values. The Chi-Square test and Kruskal-Wallis test were used to evaluate the differences responses between modes of administration. Demographic variables including sex, age, household income, expense, number of dependents showed no significantly different between the samples. Across all three modes, participants' response rate was higher, higher interpretation rate, and more costs of survey in face to face sample, but no statistically different. There was no difference in WTP maximum of life saving scenario among three modes of administration. Online elicitation can be more successful in generating valid responses than paper-based surveys, especially for sensitive issues. It may be possible to extend our findings to other valuation methods, and further work should consider the stability of choice preference elicitation techniques across different administration modes.

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“…The 3-level European Quality of Life Scale (EQ-5D-3L) is a standardised self-report measure of health-related quality of life which takes approximately 5 minutes to complete. It comprises five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, with each dimension recording responses at one of three levels: no problems, some problems, and extreme problems (Lewis and Pelosi, 1990). EQ-5D-3L ratings are commonly converted into composite utility scores using country-specific value sets, which measure people's preferences in relation to health and weight each of the levels in each EQ-5D-3L dimension accordingly.…”

Section: Scre E Ni Ngmentioning

confidence: 99%

“…A secondary cost-utility analysis explored effectiveness in terms of Quality-Adjusted Life Years (QALYs). EQ-5D-3L utility scores were used to calculate QALY improvements during the period of the trial (6 months) using the area under the curve approach (Manca et al, 2005).…”

Section: Costsmentioning

confidence: 99%

“…The uncertainty of these estimates was explored first, by bootstrapping 1000 resamples to generate a new distribution of estimates and plotting these onto a costeffectiveness plane for interpretation and then, by constructing cost-effectiveness acceptability curves (CEAC This is an open access protocol distributed under the terms of the C rea tiv e C o m m o n s A ttrib u tio n Licen se C rea tiv e C o m m o n s A ttrib u tio n Licen se (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited CEAC is a plot of the probability of the intervention being cost-effective (y-axis) for a range of willingness to pay thresholds per unit improvement in outcome (x-axis) (Fenwick et al, 2001). Initially, for the cost-utility analysis the WHO recommendation of three times GDP per capita (Rachapelle et al, 2013, Eichler et al, 2004or a calculation based on estimates of opportunity costs (Woods et al, 2016)were considered to approximate an Indonesian willingness-to-pay threshold, but recent research on the Indonesian willingness-to-pay threshold for medical intervention enabled a more exact analysis to be conducted (Kristina et al, 2017).…”

Section: Costsmentioning

confidence: 99%

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Evaluating the Clinical Cost-effectiveness of Two Primary Mental Health Service Frameworks in Yogyakarta, Indonesia v1

Anjara¹,

Bonetto²,

Brayne³

et al. 2019

Preprint

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Ba ckground Ba ckground The World Health Organization (WHO) defines health as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. Despite its importance, mental health provisions are often limited. In 2015, Indonesia had only 773 psychiatrists for 250 million residents. This shortage of specialist mental health professionals is shared by most Low-and Middle-Income Countries (LMICs) and is reflected in the Treatment Gaps in this region indicating the very small proportion of people who receive adequate mental health care for their needs. While the median worldwide Treatment Gap for psychosis is 32.2% (Kohn et al., 2004), in Indonesia it is more than 90%. Experts suggested integrating mental health care into primary care, to help bridge this gap (Mendenhall et al., 2014). The systematic introduction of the World Health Organization Mental Health Gap Action Programme into primary care clinics across Indonesia and the presence of a 15-year-old colocation of Clinical Psychologists in Yogyakarta province's primary care clinics presented an opportunity to assess the clinical and cost-effectiveness of both frameworks. Me thods Me thods This research ("the trial") set out to develop an approach, and then implement it, to compare the adapted WHO mhGAP framework with the existing specialist framework within primary mental health services in Yogyakarta, Indonesia, through a pragmatic, two-arm cluster randomised controlled non-inferiority trial. This design enabled an examination of patients derived from whole populations in a 'real world' setting. The trial involved two phases: a pilot study in June 2016 with the objectives to refine data collection procedures and to serve as a practice run for clinicians involved in the trial; as well as a substantive trial beginning in December 2016. The 12-item General Health Questionnaire (GHQ-12) was established as a 'fairly accurate' screening tool using a Receiver Operating Curve study. Using the GHQ scoring method of 0-0-1-1, a threshold of 1/2 was identified for use in clinical setting, i.e. the context of the trial. The primary outcome was the health and social functioning of participants as measured by the Health of the Nation Outcome Scale (HoNOS) and secondary outcomes were disability as measured by WHO Disability Assessment Schedule 2.0 (WHODAS 2.0), quality of life as measured by European Quality of Life Scale (EQ-5D-3L), and cost of intervention evaluated from a health services perspective, which aimed to determine the clinical effectiveness and cost-effectiveness of both frameworks at six months. Re sul ts Re sul ts During the recruitment period, 4944 adult primary care patients attended 27 participating primary care centres. Following screening (n=1484) and in-depth psychiatric interviews (n=394), 174 WHO mhGAP arm and 151 Specialist arm participants received a formal diagnosis and were recruited into the trial. The number of required participants per treatment arm, to provide statistical power of 0.80 and statisti...

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Reliability and Validity of Hypothetical Scenarios for Estimating Willingness to Pay (Wtp) Per Quality Adjusted Life Year (Qaly) in Indonesia Setting

Cited by 3 publications

References 24 publications

Can General Practitioners manage mental disorders in primary care? A partially randomised, pragmatic, cluster trial

Can General Practitioners manage mental disorders in primary care? A partially randomised, pragmatic, cluster trial

Difference of Responses Among Face to Face, Telephone, and Online Survey: A Pilot Study in Measuring Willingness to Pay Per Qaly of Three Health Conditions

Evaluating the Clinical Cost-effectiveness of Two Primary Mental Health Service Frameworks in Yogyakarta, Indonesia v1

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